Interventions for nausea and vomiting in early pregnancy

Abstract

Background Nausea, retching and vomiting are very commonly experienced by women in early pregnancy. There are considerable physical and psychological effects on women who experience these symptoms. This is an update of a review of interventions for nausea and vomiting in early pregnancy previously published in 2003. Objectives To assess the effectiveness and safety of all interventions for nausea, vomiting and retching in early pregnancy, up to 20 weeks' gestation. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 May 2010). Selection criteria All randomised controlled trials of any intervention for nausea, vomiting and retching in early pregnancy. We excluded trials of interventions for hyperemesis gravidarum which are covered by another review. We also excluded quasi-randomised trials and trials using a crossover design. Data collection and analysis Four review authors, in pairs, reviewed the eligibility of trials and independently evaluated the risk of bias and extracted the data for included trials. Main results Twenty-seven trials, with 4041 women, met the inclusion criteria. These trials covered many interventions, including acupressure, acustimulation, acupuncture, ginger, vitamin B6 and several antiemetic drugs. We identified no studies of dietary or other lifestyle interventions. Evidence regarding the effectiveness of P6 acupressure, auricular (ear) acupressure and acustimulation of the P6 point was limited. Acupuncture (P6 or traditional) showed no significant benefit to women in pregnancy. The use of ginger products may be helpful to women, but the evidence of effectiveness was limited and not consistent. There was only limited evidence from trials to support the use of pharmacological agents including vitamin B6, and anti-emetic drugs to relieve mild or moderate nausea and 1 Interventions for nausea and vomiting in early pregnancy (Review)

ACG Clinical Guideline: Liver Disease and Pregnancy

“…Although women with HG have increased rates of low birth weight (LBW) babies, small for gestational age babies, preterm birth, and poor 5-min Apgar scores ( 31 ), outcomes are generally favorable ( 32,33 ). Management of HG is supportive, however, given the risk for electrolyte abnormalities and dehydration, hospitalization is not infrequent ( 34,35 ).…”

“…Pregnant women with suspected portal hypertension should undergo screening with upper endoscopy for esophageal varices in the second trimester (strong recommendation, low level of evidence). 35. Pregnant women who are found to have large esophageal varices should be treated with beta-blockers and/or band ligation (conditional recommendation, very low level of evidence).…”

Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy

“…Two Cochrane reviews were published recently. 62,63 Matthews et al 62 included only RCTs focusing on nausea and vomiting and excluded trials involving hyperemesis gravidarum; the review by Boelig et al 63 only included RCTs of hyperemesis gravidarum. Neither review categorized therapies depending on symptom severity.…”

The use of medicinal herbs in gynecological and pregnancy-related disorders by Jordanian women: a review of folkloric practice vs. evidence-based pharmacology

“…Flavonoids, tannins and sesquiterpenes (-bisabolol and farnesene) (Minaiyan et al 2010;Aboul et al 2012;Afifi & Kasabri 2014); coumarins, phenolic compounds, polyacetylenes, flavones, flavonols and flavonones Aboul et al 2012); Essential oil (monoterpenes), triterpenes and fatty acids (Capuzzo et al 2014). Chamomile is used as anti-nausea and antiemtic in early pregnancy (Bishop et al 2011;Matthews et al 2014) or throughout pregnancy (Broussard et al 2010;Holst et al 2011). A higher incidence of threatening miscarriages and preterm labors was observed among regular pregnant users of chamomile (Cuzzolin et al 2010).…”

“…It used to treat dysmenorrhea and delayed menses (Flores & Quinlan 2014). Clinical studies showed that Matricaria aurea (Chamomile) is used for nausea and vomiting intervention in early pregnancy (Bishop et al 2011;Matthews et al 2014) or throughout pregnancy (Broussard et al 2010;Holst et al 2011). A higher incidence of threatening miscarriages and preterm labors was observed among regular pregnant users of chamomile (Cuzzolin et al 2010).…”